Rhode Island
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
No racial disparities were found in Rhode Island for these lung cancer metrics.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 64.4 and significantly higher than the national rate of 54.6.
- Rhode Island ranks 41st among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 34%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Rhode Island is 33.3%, which is significantly higher than the national rate of 26.6%.
- It ranks 1st among the 42 states with survival data, placing it in the top tier.
- Over the last five years, the survival rate in Rhode Island improved by 41%.
Early Diagnosis:
- 31.9% of cases are caught at an early stage, which is significantly higher than the national rate of 26.6%.
- It ranks 3rd among the 47 states with data on diagnosis at an early stage, placing it in the top tier.
- Over the last five years, the early diagnosis rate in Rhode Island improved by 23%.
Lung Cancer Treatment
Surgical Treatment:
- Rhode Island ranked 3rd (out of the 47 states with available data) with 26.9% of cases undergoing surgery as part of the first course of treatment.
- This is significantly higher than the national rate of 20.8% and puts Rhode Island in the above average tier.
- Over the last five years, the percent of cases undergoing surgery in Rhode Island improved by -31%.
Lack of Treatment:
- Rhode Island ranked 1st (out of the 47 states with available data) with 13.2% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Rhode Island in the top tier.
- Over the last five years, the percent of cases receiving no treatment in Rhode Island did not change significantly.
Screening
Screening for High Risk:
- In Rhode Island, 9.1% of those at high risk were screened, which was significantly higher than the national rate of 4.5%.
- It ranks 6th among all states, placing it in the top tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Rhode Island was one of the 49 states whose Medicaid fee-for-service programs covered lung cancer screening as of October 2023.
- In addition, their program used recommended guidelines for determining eligibility and did not require prior authorization or copays.
Prevention
Tobacco Use:
- The smoking rate in Rhode Island is 12.4% and not significantly different than the national rate of 13.5%.
- It ranks 14th among all states, placing it in the average tier.
Radon:
- In Rhode Island, 21.4% of radon tests results were at or above the action level recommended by EPA.
- It ranks 22nd among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 55.1 per 100,000 population among Black individuals in Rhode Island, not significantly different than the rate of 56.3 among Black individuals nationally, and significantly lower than the rate of 67.7 among white individuals in Rhode Island.
- The five-year survival rate is 30.7% among Black individuals in Rhode Island, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 33.1% among white individuals in Rhode Island.
- 35.4% of lung cancer cases are diagnosed at an early stage among Black individuals in Rhode Island, significantly higher than the rate of 23.2% among Black individuals nationally, and not significantly different than the rate of 32.0% among white individuals in Rhode Island.
- 23.8% of Black individuals with lung cancer in Rhode Island underwent surgery, not significantly different than the rate of 17.0% among Black individuals nationally, and not significantly different than the rate of 27.3% among white individuals in Rhode Island.
- Other lung cancer rates are not available for Black individuals in Rhode Island due to too few cases over the time period to allow for accurate analysis.
Latino individuals:
- The rate of new lung cancer cases is 31.0 per 100,000 population among Latino individuals in Rhode Island, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 67.7 among white individuals in Rhode Island.
- State-level survival rates are not available for Latino individuals at this time. Nationally, the five-year survival rate among Latino individuals is 22.7%, not significantly different than the rate of 25.0% among white individuals.
- 30.3% of lung cancer cases are diagnosed at an early stage among Latino individuals in Rhode Island, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 32.0% among white individuals in Rhode Island.
- 21.1% of Latino individuals with lung cancer in Rhode Island underwent surgery, not significantly different than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 27.3% among white individuals in Rhode Island.
- 15.5% of Latino individuals with lung cancer in Rhode Island did not receive any treatment, significantly lower than the rate of 26.1% among Latino individuals nationally, and not significantly different than the rate of 13.3% among white individuals in Rhode Island.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 30.2 per 100,000 population among Asian or Pacific Islanders individuals in Rhode Island, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 67.7 among white individuals in Rhode Island.
- State-level survival rates are not available for Asian or Pacific Islander individuals at this time. Nationally, the five-year survival rate among Asian or Pacific Islander individuals is 28.6% and significantly higher than the rate of 25.0% among white individuals.
- Other lung cancer rates are not available for Asian or Pacific Islander individuals in Rhode Island due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- Lung cancer rates are not available for Indigenous Peoples (American Indians/Alaska Natives) in Rhode Island due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Rhode Island falling into the top tier, the state still has a lot of work to do to make sure that more of those at high risk for lung cancer are screened.
Rhode Island has improved access to expanded screening by covering it through its fee-for-service Medicaid program. The Lung Association encourages all states to cover lung cancer screening based on the latest guidelines across all fee-for-service and managed care plans without any financial or administrative barriers in their Medicaid programs.
Rhode Island falls into the top tier for percent of patients receiving no treatment. Some patients do refuse treatment, but issues such as fatalism and stigma can prevent eligible patients from accessing treatment that may save or extend their lives. All patients should work with their doctors to establish a treatment plan and goals.